Letter: Medicare lost in the hands of Americans for Prosperity

Kansas Gov. Sam Brownback, center, chats with Lt. Gov. Jeff Colyer, left, and U.S. Sen. Pat Roberts, right, before Roberts files for re-election. Brownback has signed a bill that adds Kansas to a compact of states hoping to be excluded from parts of the federal health care overhaul.

Gov. Sam Brownback has signed House Bill 2553, which would transfer control of Medicare from the federal government to the tender loving care of the governor and the Kansas Republican Party.

This is not surprising, since Brownback has long been in the pocket of Americans for Prosperity (prosperity for some, the poor house for you). David Koch is chairman of the board of AFP and a strong backer of Brownback. Koch was a candidate for vice president on the Libertarian Party ticket in 1980, with a platform for the abolition of Social Security, Medicare, the FBI, the CIA and public education.

At that time, the Republican Party had not lost its mind and refused the Koch-backed John Birch Society a place in the Republican Party. Fast forward to today. Brownback had an AFP member on his staff. This is the best example that voting does have consequences. You may lose your Medicare to the governor and his backers, the AFP.

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Hey Jack, did you know that your good buddy Obama is cutting Medicare $900 billion over ten years in order to pay for his boondoggle Obamascare? And you're worried about Brownback. OBTW, the State does not have any power over Medicare, I don't care how many bills they pass. Medicare is federally funded, and that will not change.

Those "cuts" were subsidies Medicare paid to insurance companies. The result of those "cuts" is to extend the solvency of the Medicare program by a decade. And every single Republican in Washington has voted more than once to keep the cuts and reinstate the waste.

American Heritage Dictionary definition of fascism: "...a system of government that exercises a dictatorship of the extreme right, typically through the merging of state and business leadership, together with belligerent nationalism."

The program does have to be tweaked now and then to make sure it stays solvent. Reagan, in the '80s, had Boomers pay extra tax to shore up the account for the future of the "pig in the python." But the idea that legislators can dip into the fund is a myth. It is a protected trust and it is illegal to use it for something other than its stated purpose. This is not doomsday for Medicare or Social Security.

What the Koch libertarian/John Birch agenda actually wants is to privatize any and all public trusts or holdings (the commonwealth). This is based on the neoliberal idea that the "free market" is itself its own democracy. The road to prosperity according to this economic theory is unfettered "capitalism." However, it leads to a faux-capitalism because commerce of itself has no conscience. We used to call it "dog eat dog." Venture capitalization morphs into vulture capitalization.

The public should not surrender its commonwealth to privatizers, because the private sector is increasingly ruled by fewer and fewer capital magnates who are hoarders of wealth and have no real ties to the commoner. It isn't that they are all Darth Vaders; but they are sequestered and very focused on self-interest, even if they do philanthropy. The whole purpose of public holdings is to guard the interest of the consumer/public/demand sector -- the 99%.

One of the favorite philosophers of libertarian economics was a man named Friedrich Hayek who wrote a book called "The Road To Serfdom." The whole idea is that the state is the enemy of your liberty and prosperity. And it can be in its most totalitarian form. But the state in a democratic representative republic, when functioning, is under control of the taxpayer, not vice-versa. We the People own and by proxy control our commons (the "common welfare" as the Constitution puts it).

In short, the actual road to serfdom can be realized by the full adoption of Hayek's ideas. History reveals the pattern: lowering taxes on the rich and deregulation of business leads to monopolies which leads to broken economy (recessions) which leads to austerity measures which break the back of any middle class or its government. In short, the road to serfdom is the result of libertarian economics. It is one-sided, extreme, and dangerous to national health.

Why the Kochs would want this future for you is another matter. Theirs is a reaction to the old Soviet machine their father worked under as he built his fortunes in oil and passed the business on. It is the equal and opposite reaction, you might say. Meet the new boss, same as the old boss.

30.2% in cuts to Medicare Advantage. Medicare Advantage is a very popular private insurer that those who are enrolled in like very much. It provides extensive services beyond those of Medicare. Even Chuck Shumer has asked to back off the cuts to Medicare Advantage. Apparently Medicare Advantage falls under the "if you like your insurance you can keep your insurance". Oh, that's right. That was a lie.

35% in cuts to the reimbursement rates to hospitals and doctors. This means they will get reimbursed even less than they are now, and they lose money at the current rates. It will be even harder to find a doctor who will accept Medicare patients when their reimbursement rates cause them to lose even more money than they do now. And hospitals have to raise the costs to private insurance payers to absorb the traditional losses Medicare generates. It's called cost shifting. That will increase, causing all of our rates to go up.

The remaining 34.8% will come from imaginary savings in "other" areas loosely defined as fraud reduction, efficiencies in administration and other areas which will probably not happen, so the money will come from taxpayers to make up the difference.

Don't you think you people have hurt the obamacare cause enough with all the lies that you have told up to this point? Do you really imagine you can just keep piling lie after lie on and people won't figure it out? Perhaps all the lies told have some impact on why the majority of Americans strongly disapprove of obamacare and obama.

And the cuts were not to increase the solvency of Medicare. The CBO has already said obama can't count those cuts twice. That's another lie. Cuts to Medicare are to fund obamacare. That's what they do. He is robbing senior citizens to provide insurance for those who don't want to buy their own.

in his libertarian party ticket when he ran for vice -president in 1980.

In 1980, David Koch ran as a vice presidential candidate on the Libertarian Party ticket. His party only got a smattering of votes. At the time, Koch reportedly advocated the abolition of Social Security, Medicare, the FBI, CIA and public schools. That was just a part of his radical platform. Today, many of his views have become mainstream within the Republican Party. There are calls for the privatization of Social Security and Medicare, to mistrust the intelligence agencies, and to foster home schooling and private schools over public schools. What once were considered wacko ideas are now part of regular political discourse.

Moreover, I'll point out that none of the cuts were made to patient benefits. The purpose of Medicare Advantage was to utilize the power of private enterprise to reduce costs, a task at which private industry was a dismal failure.

Other cuts were made to reimbursing providers for seeing uninsured patients, made unnecessary by expanding Medicaid.

The people of Kansas will not sign over more control to big brother. Kansas, along with most other states, will not resign itself to bankruptcy..... Putting itself in the position of begging on its knees to big brother for more federal bailouts.

I don't know whether you really just believe what you are told or if you simply do not understand the factual statutes you read. All anyone has to do is read the actual ACA LAW. It is there, it is fact, it is the law and it does NOT state what you are marketing; not even close. While I recognize statute law is definitely confusing and can be challenging if one is not accustomed to it, but it is usually not so convoluted that one can misinterpret the main issue being addressed.

The explanation provided by Still Safe at Home is correct and well stated. The facts cannot be altered or changed to fit someone's defense for their party of choice or candidate of their choice. It is one thing to argue merits or deficits of an issue but quite another to totally negate the facts of an issue. The CBO's documents are public information as are the laws of this state and of our nation. It is self defeatist to misrepresent a law that is readily available to prove it's contents.

Either way, AshMcG, the assertions you have stated are simply inaccurate and not fact nor truth based.

Ok, you do not understand at all how Medicare and Medicare Advantage work. For example, you state, "The purpose of Medicare Advantage was to utilize the power of private enterprise to reduce costs, a task at which private industry was a dismal failure".

Medicare Advantage has been overwhelmingly popular and it's usage has continued to significantly increase every year. It is a very complex and complicated program. However, overall, it's origination was to offer flexibility, choice and additional benefits and coverage for those eligible for Medicare. Some plans offer Medicare Advantage plans for the same Part B premium cost as straight Medicare; others, offer plans with a higher premium amount based on the benefits and coverage made available. Therefore, where Medicare remuneration is not sufficient to fund for additionally offered benefits/coverage, the federal government allows the insurer to raise their rates to accommodate those additional benefits and costs.

While there have been 'kinks' along the way since initially established, those have been ironed out and the program has continued with success, not failure. Had there been evidential failure with such plans, then Medicare Advantage would have been dropped altogether and/or revised into a very different program option.

The 'cuts' made to Medicare, under the ACA, were not totally due to nor attributed to being representative of the reductions providers would realize as a result of Medicaid expansion in the states that chose that option (24). The reduction of that reimbursement was not a 'cut', it simply represents a reduction in remuneration to healthcare providers proportionate to patients seen. The 'cuts' made to Medicare under the ACA mandate represent funding that has been carved out of operational funding, in general, and effects all Medicare beneficiaries as a result.

Those cuts are most represented by drastic reduction in all healthcare Part B providers and to Part A hospital providers. However, the largest majority effected are the Part B healthcare providers. In fact, the reductions are so severe there are a large number of these providers who will be forced to discontinue treating Medicare beneficiaries as the amount of Medicare Part B reimbursements for procedures performed simply will not even cover the costs associated with providing them. The cuts are severe and their consequences real.

As a result, every Medicare beneficiary will be effected, one way or the other. Either they will have to find another physician or healthcare provider and/or their current physician may choose to no longer be a Medicare participating provider and they will have to pay out of pocket for the difference between Medicare's allowed charge and the nonparticipating provider's actual charge in addition to their out of pocket deductible and coinsurance amounts. However, some physicians may choose not to even be a nonparticipating Medicare provider since the reimbursement cuts will represent more than the nonparticipating provider charge allowed by Medicare (115% of Medicare's actual allowed charge for the Medicare participating provider for the same procedure).

When reading the ACA mandate as it references the Medicare program, it is clearly stated what the Medicare effected areas and reductions are. The ACA is available on-line and is easily accessible for verification.

If the savings from reducing provider payments (which were, again, inflated to cover the cost of the uninsured) are so onerous to providers that providing medicine no longer makes good business sense, then we'd see some sort of mass exodus from doctors.

The Gov. Brownback is driving the Kansas car off the cliff. Fact: did you know Pres. Obama's approval rating in Kansas is 34% who approve and Gov. Brownback's approval rating in the same poll is 32%. How many of you are going to stay in the car with the Gov.

Using a logic of your choosing based upon a less than accurate ASPE Issue Brief that is based upon not only very loosely compiled 'estimates' but also upon data from 2005-2012 (and one data source from 1st quarter 2013) proves nothing. The data used is 'estimated' with error margins outside the valid spectrums and additionally provides these loose 'estimates' to a time period over a year earlier than the actualized period of impact as it relates to the issues being discussed in this comment thread.

The brief, itself, clearly documents the invalidity of the data, if one actually cares to read the footnotes. For example:

"[1] 2011 data come from the NAMCS Electronic Records Supplement and 2012 from the NAMCS Electronic Health Records Survey, both conducted by mail. Unweighted response rates were between 58-67% depending on the year. Estimates used sample weights to yield nationally-representative estimates, and standard errors accounted for the complex survey design. Estimates excluded pediatricians and any respondent missing information on either acceptance of new Medicare or privately insured patients. Respondents missing information on acceptance of both ranged from 6-12%, depending on the year"

"[4] Beck, M. “More Doctors Steer Clear of Medicare”, Wall Street Journal 7/29/13 p.A1, vCCLXII #24. This article reported that the number of physicians opting out of Medicare increased from 3,700 in 2009 to 9,539 in 2012."

"[4] Beck, M. “More Doctors Steer Clear of Medicare”, Wall Street Journal 7/29/13 p.A1, vCCLXII #24. This article reported that the number of physicians opting out of Medicare increased from 3,700 in 2009 to 9,539 in 2012."

"[6] The MedPAC survey includes all Medicare beneficiaries and does not distinguish Medicare FFS enrollees from those in Medicare Advantage (MA) plans because of the technical difficulty in obtaining reliable self-identification of FFS or MA enrollment from surveyed individuals"

AshMcG, first of all, you need to pick and choose accurate reports that are based on pure primary data rather than reports that have used various third party statistics and data which may or may not be legitimately extracted either. This brief you are using is nothing more than an estimate based upon numbers chosen from many different reference sources. It is absurd as it reflects nothing that can be considered 'valid' and that fact is easily discernable from the footnotes I have extracted from the brief itself, above.

This is an area I have expertise in and to use a brief such as this whose 'estimates' have been extracted using statistics found in other various documents and then extrapolating those in order to develop more statistics represents a novice attempt, at best, which is quickly obvious to someone with any experience and knowledge in the field.

Finally, have you yet to read the ACA law itself as it pertains to the issue at hand? That, after all, was the issue at hand.